A problem with COVID-19 incidence rate accuracy

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When calculating incidence or prevalence rates for a disease in a population, what are two reasons the case counts might be incorrect?

Early on in the COVID-19 pandemic, much of the case report data came from hospitals. Describe two examples of how this could have caused a problem with COVID-19 incidence rate accuracy.

The cumulative incidence of a disease in a population is 8 per 1000 persons over one year. The incidence density for the same disease and population is 2.5 per 1000 person-years. Explain specifically why these two values are different. Which is more accurate and why?